A Cross-Sectional Study on Anti Hepatitis B Immune Status in Vaccinated Healthcare Workers in the West Pomeranian Region of Poland

Background: Hepatitis B vaccination, recommended for medical staff, has a non-response rate of 5% to 32%. In Poland, there is no standardized postvaccination protocol to verify immunity.
Objectives: To determine the fraction of those who have been vaccinated against HBV (with a complete course followed/not followed by a booster) but not checked for serological evidence of hepatitis B immunity and to detect anti-HBs levels in this group by anonymous cross-sectional sero-survey.
Patients and Methods: Surgical/gynecological staff from 16 randomly selected hospitals in West Pomerania, Poland, were surveyed between July 2010-January 2011. EIA system version 3.0 was used to detect anti-HBs.
Results: Of 488 participants (439 females, median age 42 years) who were previously vaccinated (1-21 years ago), anti-HBs status was not determined after HBV vaccination in 361 individuals (74.0%; 95% CI: 69.9-77.7%), 5% (18/361) of whom had an anti-HBs titer of 0.0 mIU/ml (12/18 who were given booster doses developed anti-HBs > 10 mIU/ml) and 7.2% (26/361) of whom had an anti-HBs titer of 0.1-10 mIU/ml. The multivariate logistic regression model revealed that working in a teaching hospital was associated with lower odds of not being checked for anti-HBs after HBV vaccination (OR 0.22, 95% CI: 0.14-0.35; P = 0.0001).
Conclusions: The lack of a strict post-HBV vaccination policy to confirm immunity results in the majority of surgical/gynecological staff not checking their anti-HBs levels after HBV immunization. It is unknown whether the absence of current serological evidence of hepatitis B immunity can be attributed to non-response, the waning of vaccine-induced immunity, or preserved anamnestic response. The lack of a booster vaccination response in a fraction of subjects suggests that they are non-responders. Strict post-vaccination testing to document immunity remains the key practice to detect non-responders among medical staff.

• Implication for health policy/practice/research/medical education:
  The study discusses strict post HBV vaccination testing to document immunity as a key practice to detect non-responders among medical staff and points at the possible consequences of the lack of such a policy. Issues discussed in this article can be useful for those at risk of occupational HBV infection, specialists in the field of occupational medicine, infectious diseases and health policy makers.
• Please cite this paper as:
  Ganczak M. A Cross-Sectional Study on Anti Hepatitis B Immune Status in Vaccinated Healthcare Workers in the West Pomeranian Region of Poland. Hepat Mon. 2012;12(3): 185-9. DOI: 10.5812/hepatmon.850

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